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General NPI Number Information
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NPI Number | 1245246032
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Entity Type | Organization
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Legal Business Name | EITOKU COMPANY INC
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 07/06/2023
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Provider Practice Location Address
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Address Line | 18 4TH STREET
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City | GONZALES
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State | CA
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Zip | 93926-0808
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Country | US
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Telephone | 831-675-3643
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Fax | 831-675-3086
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Provider Business Mailing Address
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Address Line | PO BOX 808
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City | GONZALES
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State | CA
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Zip | 93926-0808
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Country | US
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Telephone | 831-675-3643
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Fax | 831-675-3086
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Authorized Official
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Title or Position | OWNER
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Name | MR. JIMMY KEN EITOKU
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Credential | PHARM. D
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Telephone | 831-675-3643
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY43808
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License Number State | CA
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